Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia.
Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia.
J Cancer Surviv. 2024 Jun;18(3):972-982. doi: 10.1007/s11764-023-01348-7. Epub 2023 Feb 24.
Managing cancer-related fatigue requires individuals to adopt a range of self-management behaviours. However, clinicians report the lack of clear guidance on self-management support practices hinders their provision of supportive care. To develop consensus on a framework of core practices required by health professionals to deliver effective self-management support to cancer patients and survivors experiencing cancer-related fatigue.
A preliminary framework of 47 practice items (14 Key Practices, 33 Practice Components) was derived from a systematic review, and a self-management support capability outline for primary care professionals. This preliminary framework was presented for consensus rating and comment in a two-round modified Delphi study conducted with a panel of health professionals, research academics, and cancer consumers.
Fifty-two panel participants comprising consumers (n = 25), health professionals (n = 19), and researchers (n = 16) were included in Round 1 of the modified Delphi study. Feedback from the panel produced consensus on retaining 27 of 47 original practice items without change. Seventeen items (including 12 modified, and 5 newly created practice items) were sent to the panel for rating in Round 2. Thirty-six experts produced consensus on retaining all 17 practice items in Round 2. The final framework comprised 44 items (13 Key Practices, 31 Practice Components).
The practice framework offers an evidence- and consensus-based model of best practice for health professionals providing self-management support for cancer-related fatigue.
This framework is the first to focus on quality provision of self-management support in managing cancer-related fatigue, one of the most prevalent symptoms experienced by cancer patients and survivors.
管理与癌症相关的疲劳需要个人采取一系列自我管理行为。然而，临床医生报告缺乏明确的自我管理支持实践指南，这阻碍了他们提供支持性护理。为了就健康专业人员提供有效的自我管理支持以管理癌症患者和幸存者的与癌症相关的疲劳所需的核心实践框架达成共识。
从系统评价和初级保健专业人员的自我管理支持能力大纲中得出了一个初步的包含 47 项实践内容（14 项关键实践，33 项实践组成部分）的框架。这个初步的框架在两轮修改后的德尔菲研究中呈现给健康专业人员、研究学者和癌症患者的小组进行共识评分和评论。
共有 52 名小组参与者（包括消费者 25 名，卫生专业人员 19 名和研究人员 16 名）参加了修改后的德尔菲研究的第一轮。小组的反馈意见达成了保留 47 项原始实践内容中的 27 项的共识，而无需更改。17 项内容（包括 12 项经修改和 5 项新创建的实践内容）发送给小组进行第二轮评分。36 名专家在第二轮中达成了保留所有 17 项实践内容的共识。最终框架包括 44 项内容（13 项关键实践，31 项实践组成部分）。
该实践框架为提供与癌症相关的疲劳的自我管理支持的健康专业人员提供了一个基于证据和共识的最佳实践模型。
这个框架是第一个专注于提供与癌症相关的疲劳管理的自我管理支持的质量的框架，这是癌症患者和幸存者最常见的症状之一。
